Body mass index versus dual energy x-ray absorptiometry-derived indexes: Predictors of cardiovascular and diabetic disease risk factors

Background: Body composition is important for health screening, but appropriate methods for unilateral lower extremity amputees have not been validated. Objectives: To compare body mass index adjusted using Amputee Coalition equations (body mass index–Amputee Coalition) to dual-energy X-ray absorptiometry in unilateral lower limb amputees. Study design: Cross-sectional, experimental. Methods: Thirty-eight men and women with lower limb amputations (transfemoral, transtibial, hip disarticulation, Symes) participated. Body mass index (mass/height2) was compared to body mass index corrected for limb loss (body mass index–Amputee Coalition). Accuracy of classification and extrapolation of percent body fat with body mass index was compared to dual-energy X-ray absorptiometry. Results: Body mass index–Amputee Coalition increased body mass index (by ~ 1.1 kg/m2) but underestimated and mis-classified 60% of obese and overestimated 100% of lean individuals according to dual-energy X-ray absorptiometry. Estimated mean percent body fat (95% confidence interval) from body mass index–Amputee Coalition (28.3% (24.9%, 31.7%)) was similar to dual-energy X-ray absorptiometry percent body fat (29.5% (25.2%, 33.7%)) but both were significantly higher ( p < 0.05) than percent body fat estimated from uncorrected body mass index (23.6% (20.4%, 26.8%)). However, total errors for body mass index and body mass index–Amputee Coalition converted to percent body fat were unacceptably large (standard error of the estimate = 6.8%, 6.2% body fat) and the discrepancy between both methods and dual-energy X-ray absorptiometry was inversely related ( r = −0.59 and r = −0.66, p < 0.05) to the individual’s level of body fatness. Conclusions: Body mass index (despite correction) underestimates health risk for obese patients and overestimates lean, muscular individuals with lower limb amputation. Clinical relevance Clinical recommendations for an ideal body mass based on body mass index–Amputee Coalition should not be relied upon in lower extremity amputees. This is of particular concern for obese lower extremity amputees whose health risk might be significantly underestimated based on body mass index despite a “correction” formula for limb loss.

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Infant feeding method and obesity: body mass index and dual-energy X-ray absorptiometry measurements at 9–10 y of age from the Avon Longitudinal Study of Parents and Children (ALSPAC)

American Journal of Clinical Nutrition ◽

10.1093/ajcn/85.6.1578 ◽

2007 ◽

Vol 85 (6) ◽

pp. 1578-1585 ◽

Cited By ~ 71

Author(s):

André M Toschke ◽

Richard M Martin ◽

Rüdiger von Kries ◽

Jonathan Wells ◽

George Davey Smith ◽

...

Keyword(s):

Body Mass Index ◽

Longitudinal Study ◽

Infant Feeding ◽

Body Mass ◽

Dual Energy ◽

Feeding Method ◽

X Ray ◽

Parents And Children ◽

Avon Longitudinal Study

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Identification of Endothelial Proteins in Plasma Associated With Cardiovascular Risk Factors

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.121.316779 ◽

2021 ◽

Author(s):

Maria J. Iglesias ◽

Larissa D. Kruse ◽

Laura Sanchez-Rivera ◽

Linnea Enge ◽

Philip Dusart ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Risk Factor ◽

Total Cholesterol ◽

Body Mass ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factor ◽

Venous Disease

Objective: Endothelial cell (EC) dysfunction is a well-established response to cardiovascular disease risk factors, such as smoking and obesity. Risk factor exposure can modify EC signaling and behavior, leading to arterial and venous disease development. Here, we aimed to identify biomarker panels for the assessment of EC dysfunction, which could be useful for risk stratification or to monitor treatment response. Approach and Results: We used affinity proteomics to identify EC proteins circulating in plasma that were associated with cardiovascular disease risk factor exposure. Two hundred sixteen proteins, which we previously predicted to be EC-enriched across vascular beds, were measured in plasma samples (n=1005) from the population-based SCAPIS (Swedish Cardiopulmonary Bioimage Study) pilot. Thirty-eight of these proteins were associated with body mass index, total cholesterol, low-density lipoprotein, smoking, hypertension, or diabetes. Sex-specific analysis revealed that associations predominantly observed in female- or male-only samples were most frequently with the risk factors body mass index, or total cholesterol and smoking, respectively. We show a relationship between individual cardiovascular disease risk, calculated with the Framingham risk score, and the corresponding biomarker profiles. Conclusions: EC proteins in plasma could reflect vascular health status.

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